Multi Level Multileaf Collimator Leaf Tip Shape Effects and Penumbra Optimization

ABSTRACT

A multi level multileaf collimator employs leaves with leaf tips having a non-square shape in a beam&#39;s eye view to improve beam shaping effect and penumbra performance. The multi level multileaf collimator includes a first multileaf collimator in a first level comprising beam blocking leaves longitudinally movable in a first direction, and a second multileaf collimator in a second level comprising beam blocking leaves longitudinally movable in a second direction. The first direction may be generally parallel with the second direction and the leaves of the first multileaf collimator may laterally offset the leaves of the second multileaf collimator. The beam blocking leaves of the first multileaf collimator may comprise an end portion having a non-square shape in a beam&#39;s eye view.

This application is a continuation of U.S. application Ser. No.14/225,411 filed Mar. 25, 2014, entitled “MULTI-LEVEL MULTILEAFCOLLIMATOR LEAF TIP SHAPE EFFECTS AND PENUMBRA OPTIMIZATION,” thedisclosure of all of which is incorporated herein by reference in itsentirety.

BACKGROUND

This disclosure relates generally to radiation apparatuses and methods,and in particular to multi level multileaf collimator (MLC) leaf tipeffects and penumbra optimization using multi level MLCs.

Multileaf collimators are widely used in radiotherapy machines tosupport various treatments including intensity-modulated radiationtherapy (IMRT) and volumetric modulated arc therapy (VMAT). Conventionalmultileaf collimators include a single level of a plurality of beamblocking leaves arranged in two opposing banks or arrays. Each leaf in abank is longitudinally movable relative to a leaf in the opposing bank.In operation, each of the individual leaves is positioned to block aportion of a radiation beam passing through the volume occupied by theleaf. The combined positioning of all leaves defines one or moreapertures through which the unblocked radiation beam passes, and theaperture(s) define(s) the shape of the radiation beam directed to atreatment field in an isocenter plane.

It would be desirable to provide MLCs that can shape beams with highresolution so that the shaped beam conforms to a target volume as closeas possible. Conventional single level MLCs have been designed toprovide higher beam shaping resolution by making the beam blockingleaves thin. However, reducing the width of leaves to improve MLCresolution has limitations and imposes challenges to MLC constructionand operation. For MLCs using screw leaf drive systems for example, longslender drive screws may be susceptible to column buckling in a way thatscales dramatically worse with smaller screw diameters. Motors with asmaller diameter may also be required.

Conventional single level MLCs employs square leaf tips in a beam's eyeview. Therefore, even with width resolution of 5-10 mm, conventionalsingle level MLCs can only create a “stairstep” approximation of thedesired treatment field.

Furthermore, conventional single level MLCs use single leaf tip design,which is generally optimized for penumbra performance for a smallspecific area in the treatment field but not for the other areas orlarge fields. Further, while single leaf tip design may provide optimalpenumbra performance on a specific field contour, it may perform lessdesirably on various other contours due to the finite resolution of theleaf width and leaf tip geometry.

SUMMARY

Embodiments of multi level MLCs with various leaf tip designs aredescribed to improve the shaping of treatment field perimeters. Alsodescribed are methods of treatment panning and penumbra optimization oftreatment fields using multi level MLCs. Other embodiments are describedfurther herein.

BRIEF DESCRIPTION OF THE DRAWINGS

These and various other features and advantages will become betterunderstood upon reading of the following detailed description inconjunction with the accompanying drawings and the appended claimsprovided below, where:

FIG. 1 schematically illustrates a radiation system that includes amulti level MLC in accordance with some embodiments of this disclosure;

FIG. 2 is a cross-sectional view of a portion of the multi level MLCshown in FIG. 1, taken along line A-A;

FIG. 3 schematically shows the shaping effects of square leaf tips on atwo level parallel MLC;

FIG. 4 is a side view of an exemplary chamfer leaf according to someembodiments of this disclosure;

FIG. 5 is a beam's eye view of the exemplary chamfer leaf shown in FIG.4;

FIG. 6 schematically shows the shaping effects of chamfer leaves on atwo level parallel MLC according some embodiments of this disclosure;

FIGS. 7A and 7B shows images of fields shaped by square leaf tips andchamfer leaf tips according to some embodiments of this disclosure;

FIG. 8 is an enlarged view of a shaped field showing the shaping effectsof chamfer leaf tips with different chamfer angles according to someembodiments of this disclosure;

FIGS. 9A-9C schematically show various chamfer leaf designs for leaftransition in a multi level MLC according to some embodiments of thisdisclosure;

FIGS. 10A-10B schematically show exemplary chamfer leaf designsaccording to some embodiments of this disclosure;

FIG. 11 schematically shows an exemplary symmetrical finger leaf designand the combined shaping effects according to some embodiments of thisdisclosure;

FIG. 12 schematically shows exemplary asymmetrical finger leaf designsand the combined shaping effects according to some embodiments of thisdisclosure;

FIG. 13 schematically illustrates an exemplary treatment planning methodaccording to some embodiments of this disclosure;

FIGS. 14A-14C schematically illustrate an exemplary method of improvingpenumbra performance using a multi level MLC according to someembodiments of this disclosure;

FIGS. 15A-15D schematically illustrate another exemplary method ofimproving penumbra performance using a multi level MLC according to someembodiments of this disclosure;

FIGS. 16A-16D schematically illustrate a further exemplary method ofimproving penumbra performance using a multi level MLC according to someembodiments of this disclosure;

FIGS. 17A-17D show images of field edges shaped by a conventional singlelevel MLC and two level MLCs according to embodiments of thisdisclosure; and

FIGS. 18A-18C show images of effective penumbra produced by aconventional single level MLC and two level MLCs according toembodiments of this disclosure.

DETAILED DESCRIPTION

Various embodiments of multi level MLCs are described. It is to beunderstood that the invention is not limited to the particularembodiments described as such may, of course, vary. An aspect describedin conjunction with a particular embodiment is not necessarily limitedto that embodiment and can be practiced in any other embodiments. Forinstance, while various embodiments are described in connection with twolevel multileaf collimators, it will be appreciated that the disclosurecan also be practiced in multileaf collimators in more than two levels.Further, in the following description, numerous specific details such asexamples of specific components, dimensions, processes, etc. may be setforth in order to provide a thorough understanding of the disclosure. Itwill be apparent, however, to one of ordinary skill in the art thatthese specific details need not be employed to practice embodiments ofthe disclosure. In other instances, well known components or steps maynot be described in detail in order to avoid unnecessarily obscuring theembodiments of the disclosure.

Various relative terms such as “upper,” “above,” “top,” “over,” “on,”“below,” “under,” “bottom,” “higher,” “lower” or similar terms may beused herein for convenience in describing relative positions,directions, or spatial relationships in conjunction with the drawings.For example, the terms “upper level” or “lower level” may be used forease of describing some embodiments when a radiation source is on thetop of an isocenter and a multi level MLC is positioned therebetween.The use of the relative terms should not be construed as to imply anecessary positioning, orientation, or direction of the structures orportions thereof in manufacturing or use, and to limit the scope of theinvention. As used in the description and appended claims, the singularforms of “a,” “an,” and “the” include plural references unless thecontext clearly dictates otherwise. The term “or” refers to anonexclusive “or” unless the context clearly dictates otherwise.

Exemplary embodiments will now be described with reference to thefigures. It should be noted that some figures are not necessarily drawnto scale. The figures are only intended to facilitate the description ofspecific embodiments, and are not intended as an exhaustive descriptionor as a limitation on the scope of the disclosure.

FIG. 1 is a simplified illustration of a radiation system 100 thatincludes an exemplary multi level MLC according to some embodiments ofthis disclosure. The radiation system 100 may include a radiation source102 configured to produce beams 103 such as of photons, electrons,protons, or other types of radiation. By way of example, in X-rayradiotherapy, the radiation source 102 may be configured to produceX-ray radiation. The radiation system 100 may include various beamshaping components such as a primary collimator 104 and optionally asecondary collimator 106 to generally limit the extent of the beam 103as it travels away from the radiation source 102 toward an isocenterplane 108. A multi level MLC 110, which will be described in greaterdetail below, may be disposed between the radiation source 102 and theisocenter plane 108 to further shape the beam, as indicated by theshaped field 112 in the isocenter plane 108. The multi level MLC 110 andoptionally the secondary collimator 106 may rotate about an axis 109through the source 102. The radiation source 102, primary collimator104, secondary collimator 106, and the multi level MLC 110 may beenclosed in or attached to a structure such as a gantry (not shown),which may rotate about an axis such as a horizontal axis 111. Thus, theradiation system 100 may deliver treatment beams to a target in theisocenter plane 108 from various angles, and the shape and/or intensityof the beams can be dynamically adjusted by the multi level MLC 110 asthe beam angle is swept or stepped around the target.

The multi level MLC 110 may include a first MLC 120 proximal to thesource 102 (or in a first level) and a second MLC 130 distal to thesource 102 (or in a second level). As used herein, the term “MLC” or“multileaf collimator” refers to a collection of a plurality of beamblocking leaves each of which can be independently moved in and out of abeam to modify one or more parameters of the beam such as the beamshape, size, energy, or intensity etc. The beam blocking leaves of anMLC may be arranged in pairs and disposed in opposing banks. The beamblocking leaves of each pair may be longitudinally movable relative toeach other.

As shown in FIG. 1, the first and second MLCs 120, 130 may be arrangedstacked and parallel. As used herein, the term “parallel” refer to themoving direction of the leaves of the first and second MLCs 120, 130. Ineach of the first and second MLCs 120, 130, a plurality of beam blockingleaves 122, 132 may be arranged in two banks, forming a plurality ofpairs of opposing leaves. Leaves 122 of each pair of the first MLC 120in the first level can be longitudinally movable in a first direction.Leaves 132 of each pair of the second MLC 130 in the second level can belongitudinally movable in a second direction. The first direction andthe second direction may be substantially parallel. Alternatively, thefirst and second MLCs are arranged such that the first direction and thesecond direction may be non-parallel.

The leaves 122, 132 of the multi level MLC 110 may be supported by asupport body such as a frame, box, carriage or other support structures(not shown in FIG. 1). By way of example, all leaves of the first andsecond MLCs 120, 122 may be carried by a single carriage (unicarriage).The single carriage may be further moved or translated in addition tothe individual leaf travel. Alternatively, leaves 122 of the first MLC120 and leaves 132 of the second MLC 130 may be separately supported orcarried by different carriages respectively. In some embodiments, allleaves of the first and second MLCs 120, 130 in a same bank may becarried by a carriage and all leaves of the first and second MLCs 120,130 in the opposing bank may be carried by another carriage. The twocarriages may be independently moved in addition to the individual leaftravel. In some embodiments, the multi level MLC 110 of the disclosuredoes not require a movable carriage or carriages (carriageless).

The first and second MLCs 120, 130 may be disposed such that the leaves122 of the first MLC 120 may laterally offset the leaves 132 of thesecond MLC 130 as viewed from the source 102. FIG. 2 is across-sectional view of a portion of the multi level MLC 110 taken alongline A-A in FIG. 1, showing an offset arrangement of the leaves of themulti level MLC 110. As shown, each leaf of the first MLC 120 in thefirst level may offset from a leaf of the second MLC 130 in the secondlevel as viewed from the source. By way of example, a leaf of the firstMLC 120 may offset from a leaf of the second MLC 130 by substantiallyhalf a leaf. Alternatively, a gap between two adjacent leaves of thefirst MLC 120 in the first level (e.g. the gap between leaves 122 a, 122b of the first MLC 120) may be positioned substantially at the middle ofa leaf of the second MLC 130 (e.g. leaf 132 of the second MLC 130). Theoffset arrangement of leaves in different levels provides for leafprojections that are also offset at the isocenter plane. Therefore, theleaf offset arrangement may provide for substantially an equivalent ofdoubling MLC definition, or improving the resolution to half as comparedto the definition of a single level MLC with leaves of the same physicalwidth. In some embodiments, three or more MLCs may be arranged in threeor more levels such that each leaf at a level may offset e.g. by ⅓ or1/n of a leaf width as projected at the isocenter plane where n is thenumber of the MLCs. U.S. application Ser. No. 12/861,368 filed Aug. 23,2010 and entitled “Multi Level Multileaf Collimators” describes variousembodiments of multi level MLCs. U.S. application Ser. No. 12/861,368 isincorporated herein by reference in its entirety.

The individual leaves 122, 132 may have various leaf end or tipconfigurations. To facilitate description of the multi level MLC 110 ofthis disclosure, various terms such as “length,” “width,” “height,”“side,” and “end,” “tip” may be used. As used herein, the “length” of aleaf refers to the leaf dimension that is parallel to the leaflongitudinal moving direction. The “height” of a leaf refers to thedimension of the leaf along the beam direction. The “width” of a leafrefers to the dimension of the leaf that is traverse the leaf movingdirection and the direction of the radiation beam. The “side surface” ofa leaf refers to the surface of the leaf in contact with or adjacent toneighboring leaves. The “end surface” of a leaf refers to the surface ofthe leaf inserted into the field and generally transverse to the leaflongitudinal moving direction. The “end portion” of a leaf refers to theportion of the leaf including the end surface. In this disclosure, theterm “leaf tip” may be used interchangeably with the term “leaf endportion” or “end portion of a leaf.” In description of various leaf tipconfigurations, the term “beam's eye view” may be used to describe aview observed from the radiation source. The term “side view” may beused to describe a view observed from a side surface of the leaf.

Returning to FIG. 1, the individual leaves 122, 132 may have variousleaf tip configurations. For example, the end surface of a leaf may beflat. Thus, in both a side view and a beam's eye view, a leaf tip with aflat end surface may be shown as having a straight line orthogonal tothe leaf longitudinal moving direction and two right angles at each sideof the straight line.

The end surface of a leaf tip may be curved. The curved end surface maybe continuous and transverse the entire height of the leaf. Thus, in aside view, an end portion of a leaf with a curved end surface may beshown as having a curved line with a radius and two parallel lines oneither side of the curved line. In a beam's eye, an end portion of aleaf with a curved end surface may be shown as having a straight lineorthogonal to the leaf longitudinal moving direction and two rightangles on each side of the straight line. In the Detail Description andappended Claims, the term “square shape” may be used to describe a leaftip configuration which, in a beam's eye view, has a straight lineorthogonal to the leaf longitudinal moving direction and two rightangles on each side of the straight line. The term “non-square shape”may be used to describe any leaf tip configuration which, in a beam'seye view, does not have a square shape. The non-square shape in a beam'seye view may include a curved or elliptic shape and a shape of a chamferleaf which may include a combination of a straight portion and a beveledportion on each side of the straight portion as will be described ingreater detail below.

FIG. 3 schematically shows the shaping effect of a two level parallelMLC comprising leaves having leaf tips with a square shape in a beam'seye view. As shown in FIG. 3, the square leaf tips on a two level MLCmay provide conformal shaping for a field with an edge or a contour thatis substantially orthogonal to the leaf longitudinal travel direction.However, to shape a field with an increasing slope or increasing anglewith respect to the direction orthogonal to the leaf travel direction,the square leaf tips (in a beam's eye view) show poor stair-stepconformance to the field edges.

In various embodiments of this disclosure, the end surface of a leaf mayinclude a combination of a curved surface and a beveled or flat surfaceon each side of the curved surface. Both the curved surface and thebeveled surfaces may be generally transverse the entire height of theleaf. The term “chamfer leaf” may be used herein to refer to a leafwhich includes a combination of a curved end surface generallytransverse the entire height of the leaf and beveled end surfaces oneach side of the curved end surface and generally transverse the entireheight of the leaf.

FIG. 4 is a side view of an exemplary chamfer leaf tip according toembodiments of this disclosure. FIG. 5 is a beam's eye view of theexemplary chamfer leaf tip shown in FIG. 4. In a side view of FIG. 4,the end portion of a chamfer leaf may be shown as having a curve with aradius and two parallel lines. In a beam's eye view of FIG. 5, the endportion of a chamfer leaf may be shown as having a straight middleportion orthogonal to the leaf longitudinal moving direction and beveledportions on each side of the straight middle portion. The term “chamferangle” (alpha) may used herein to refer to the acute angle between thebeveled line and the straight line in a beam's eye view. By way ofexample, the straight middle portion of a chamfer leaf tip in a beam'seye view may be approximately 50% of the leaf width, and the remaining25% on each side of the middle portion can be shaped in any differentchamfer angles optimized for various different field slopes. In general,the chamfer angles may range from 5-95 degrees, or from 10-90 degrees,or from 20-80 degrees, or from 40-60 degrees. In a specific example, thechamfer angle (alpha) may be about 45 degree. In a further specificexample, the chamfer angle may be about 60 degree. In certainembodiment, a chamfer leaf may have a straight middle portion about 50%of the leaf width, with the remaining 25% on each side being beveledwith a chamfer angle of about 60 degree.

FIG. 6 schematically shows the shaping effect of a two level parallelMLC comprising chamfer leaves. The chamfer leaves comprise an endportion which has, in a beam's eye view, a straight middle portionorthogonal to the leaf longitudinal moving direction and beveledportions on each side of the straight middle portion. As shown in FIG.6, a two level MLC comprising chamfer leaves may provide substantiallyconformal shaping for a field with an edge substantially orthogonal tothe leaf longitudinal travel direction. Therefore, for shaping a fieldedge generally orthogonal to the leaf travel direction, chamfer leavesmay provide a shaping effect substantially as conformal as leaves withleaf tips having a square shape in a beam's eye view. Further, to shapea field with an increasing slope or increasing angle with respect to theleaf end surface in a beam's eye view, the chamfer leaves provide bettershaping conformance than that provided by leaves with leaf tips having asquare shape in a beam's eye view.

FIG. 7 provides further comparison on shaping fields having a 45 degreeedge or contour. The gray area in FIG. 7A is a field shaped by atwo-level MLC comprising leaves with leaf tips having a square shape ina beam's eye view. The gray area in FIG. 7B is a field shaped by atwo-level MLC comprising chamfer leaves. FIGS. 7A-7B show that the fieldedge shaped by chamfer leaves has significantly reduced undesired“scalloping” effect as compared with the field edge shaped by leaf tipshaving a square shape in a beam's eye view.

FIG. 8 is an enlarged view of a shaped field showing the shaping effectof different chamfer leaf tips. FIG. 8 shows that to shape a 45 degreefield edge, chamfer leaf tips with a steeper angle such as about 60degree chamfer angle may make the underdosed and overdosed area bothequal and most minimized, as compared to chamfer leaf tips with a 45degree chamfer angle. Therefore, chamfer leaves may be furtherconfigured to have different chamfer angles to accommodate various fieldedges in applications.

In some embodiments, the length and the number of beveled portions oneach side of the straight middle portion of a chamfer leaf may be variedto accommodate various applications. A multi level MLC of thisdisclosure may define a treatment field with variant width definitionsat the isocenter plane. For example, a finer definition may be providedin the central portion of the treatment field where precision is moreneeded. This may reduce MLC cost and increase MLC reliability comparedto an MLC with a greater number of leaves allowing fine definitionthroughout the entire treatment field. The transition of leaf width canbe gradual. For example, the width of leaves at a level can beprogressively increased with distance from the center of the treatmentfield. Each leaf at a level may have a physically different widthdimension. Alternatively, each MLC level may include leaf sections sothat the transition of leaf widths is discreet. The transition can bemade by placing transition leaves at specific locations on both levels.The transition leaves insure that the gaps between leaves project at thedesired spacing for the desired definition regions. FIGS. 9A-9C showthat in conjunction with leaf width transition, the chamfer angles ofthe leaves can remain the same (FIG. 9A), or the length of the beveledportions of the leaves can remain the same (FIG. 9B). FIG. 9C shows thattwo or more beveled portions can be made on each side of the straightmiddle portion of a chamfer leaf (compound chamfer leaf).

In some specific embodiment, the end surface of a leaf may consist oftwo beveled or flat surfaces generally transverse the entire height ofthe leaf. This may be a special case of a chamfer leaf where the curvedend surface is reduced to a one-dimensional curved line. Thus, in abeam's eye view, the end portion of such leaf may be shown as having twobeveled lines forming an acute, right, or obtuse angle. In a side view,the leaf end portion of such leaf may be shown as having a curved lineand two parallel lines on each side of the curved line. The term “50-50chamfer leaf” or “pointed chamfer leaf” may be used to refer to a leafhaving an end portion which, in a beam's eye view, has two beveledportions forming an acute, right, or obtuse angle. FIGS. 10A and 10Bshow exemplary 50-50 chamfer leaves and their shaping effects forvarious field edges.

In some specific embodiment, the end surface of a leaf may be curvedand/or rounded. The curved/rounded end surface may be machined such thatthe end surface has a curvature both transverse the entire height of theleaf and the entire width of the leaf. Thus, in both a side view and abeam's eye view, the end portion of such leaf may be shown as having acurved line with a radius. In some embodiment, the end surface of a leafmay be configured such that in a beam's eye view, the end portion of theleaf has an elliptic shape. Other designs of the end surface arepossible. For example, the end surface may have a curvature transversethe entire height of the leaf but with no curvature along the width.Alternatively, the end surface may have a curvature transverse theentire width of the leaf but with no curvature along the height.

In some embodiment, the disclosure provides a multi level MLC comprisinga first MLC in a first level comprising first beam blocking leaveslongitudinally movable in a first direction, and a second MLC in asecond level comprising beam blocking leaves longitudinally movable in asecond direction generally parallel with the first direction. The firstbeam blocking leaves of the first MLC comprise finger leaves, and thesecond beam blocking leaves of the second MLC comprise finger leaves. Asused herein, the term “finger leaf” refers to a leaf having an elongateend portion or tip with a reduced or constant width transverse theentire height of the leaf. A finger leaf may be symmetric or asymmetric.In a symmetric finger leaf, the elongate end portion with a reducedwidth extends from the middle of the leaf width. In an asymmetric fingerleaf, the elongate end portion with a reduced width extends from a sideof the leaf width. FIG. 11 schematically shows exemplary symmetricalfinger leaves and the combined shaping effects of a two level MLCcomprising the symmetrical finger leaves. FIG. 12 schematically showsexemplary asymmetrical finger leaves and the combined shaping effects ofa two level MLC comprising the asymmetrical finger leaves.

The variations of leaf tip shape may present problems for treatmentplanning (TP). TP software generally determines the instantaneous leaftip positions for an entire (static or dynamic) treatment plan based onthe ideal position of both ends of each TP strip which is to receivebeam. TP strips are assumed to have orthogonal ends controlled by twoopposing squared-tipped MLC leaves in each strip. Besides the additionalTP complexities associated with a multi-level parallel MLC, thevariations of leaf tip shape do not produce orthogonal end shapes andchange end shapes of TP strips as one leaf tip passes another (e.g. fortwo levels, a distal leaf passes a proximal leaf as shown in FIG. 13).

The disclosure provides a technique that can be used to solve theproblems caused by the variations of leaf tips in treatment planning.According to the provided technique, treatment planning (TP) may simplyconvert the TP-desired positions assumed for overly-simplistic squareleaf tips into the most-relevant averaged specific positions of variousshaped leaf tips affecting each TP strip. The proposed method is toconstrain the underdosed and overdosed strip area to be equal whethershaped by one leaf alone or by one leaf tip passing another. As usedherein, the term “treatment strip” refers to a portion or segment of atreatment field which may be defined by a pair of opposing leaves of asingle level MLC, or by two or more pairs of opposing leaves in a multilevel MLC.

Therefore, the disclosure provides a method of planning a radiationtreatment plan using a multi level MLC as described above. The multilevel MLC comprises a first MLC in a first level comprising first beamblocking leaves longitudinally movable in a first direction and a secondMLC in a second level comprising second beam blocking leaveslongitudinally movable in a second direction. The first direction may begenerally parallel with the second direction and the beam blockingleaves of the first MLC may laterally offset from the beam blockingleaves of the second MLC in a beam's eye view. The beam blocking leavesof the first and/or second MLCs may include an end portion having anon-square shape in a beam's eye view.

In the method, a treatment strip is determined using an imaginary leafwhich comprises an end portion having a square shape in a beam's eyeview. Then the position of the imaginary leaf is converted to determinethe positions of the leaves of the multi-level MLC, which include a leafend portion having a non-square shape in a beam's eye view. Indetermining a position for a first leaf of the first multileafcollimator and a position for a second leaf of the second multileafcollimator, the overdosed or underdose areas caused by the non-squareshape of the first leaf is kept substantially equal to the underdose oroverdose area caused by the non-square shape of the second leaf.

FIG. 13 schematically shows the treatment planning method describedabove using a two-level MLC according to some aspect of this disclosure.In FIG. 13, a proximal leaf (e.g. a leaf of a first MLC in a firstlevel) is shown to pass through a distal leaf (e.g. a leaf of a secondMLC in a second level) in defining a 5 mm TP strip. The D-X1, D-X2, D-0,P-X4, and P-X5 refer to the positions of the effective leaf tips(imaginary leaf with a leaf tip having a square shape in a beam's eyeview) in the 5 mm TP strip location in the respective images. Inconverting to or determining the positions of the distal and proximalleaves with an end portion having a non-square shape in a beam's eyeview, an overdose or underdose area in the treatment strip will becreated as a result of the non-square shape of the leaf end portions.According to the technique of this disclosure, the positions of thedistal leaf and proximal leaf are selected such that the underdosed andoverdosed areas are kept substantially same or the dose differences areminimized.

Radiation beam penumbra occurs in systems equipped with multileafcollimators at the edges of the radiation field where the radiationintensity decreases with distance from the full intensity region offield. This phenomenon is a combination of geometric penumbra due to theradiation source size, leaf geometry, and transmission penumbra due topenetration of the radiation beam through the ends of the multileafcollimator leaves. Geometric penumbra is a function of the source size,the thickness of the leaves, the distance of the leaves from the source,and the distance of the reference plane from the source. Transmissionpenumbra is a function of material the leaves are made from, thethickness of the leaves and the energy of the radiation beam.

The penumbra produced by the multi level MLC of this disclosure issmaller when used in shaping various field contours. Better uniformityacross large fields can be achieved. The multi level MLC of thisdisclosure can be used to optimize penumbra by utilizing different leaftip design at each level and/or utilizing relative leaf end positions ineach level. The multi level MLC according to embodiments of thisdisclosure can provide a better overall performance than single levelMLCs or than MLCs with a same leaf tip configuration.

Accordingly, in some embodiments, a multi level MLC of this disclosurecomprises a first MLC in a first level comprising beam blocking leaveslongitudinally movable in a first direction and a second MLC in a secondlevel comprising beam blocking leaves longitudinally movable in a seconddirection generally parallel with the first direction. The beam blockingleaves of the first MLC comprise a first end portion having a firstshape in a beam's eye view. The beam blocking leaves of the second MLCcomprise a second end portion having a second shape in a beam's eye viewdifferent from the first shape.

By way of example, the beam blocking leaves of the first MLC maycomprise an end portion having a non-square shape in a beam's eye viewand the beam blocking leaves of the second MLC may comprise an endportion having a square shape in a beam's eye view. The non-square shapein a beam's eye view may include a curved shape such as round orelliptic shape or a chamfer shape etc. as described above.

In some embodiments, the beam blocking leaves of the first and secondMLCs may comprise end portions having different non-square shapesrespectively in a beam's eye view. For example, the beam blocking leavesof both the first and second MLCs may be chamfer leaves but havedifferent non-square shapes in a beam's eye view in terms of chamferangles and/or dimensions of the middle portion. For another example, thebeam blocking leaves of the first MLC may be chamfer leaves and the beamblocking leaves of the second MLC may be round or elliptic in a beam'seye view. Indeed, various other combinations are possible and theappended claims are not limited to the exemplary combinations describedherein.

In some embodiment, alternative or in addition to the variouscombinations of leaf tip configurations in a beam's eye view, the beamblocking leaves of the first and second MLCs may have variouscombinations of leaf tip configurations in a side view. For example, thebeam blocking leaves of the first MLC may have a first curved shape in aside view with a first radius, and the beam blocking leaves of thesecond MLC may have a second curved shape in a side view having a secondradius, and the first radius may be different from the second radius.

The leaf tips of an MLC in each level may be optimized to addressdifferent needs e.g. targeting different areas. The penumbra by thecombination of leaves of multiple levels may be smaller than thepenumbra by leaves of each individual level alone. For example, an MLCin one level may be optimized for a center area and an MLC in anotherlevel may be optimized for an outer area. The combination of the two ormore levels may achieve a better penumbra than that an individual levelcan achieve at the center area or the outer area respectively.

The leaf tips of an MLC in each level may be optimized for differentfield contours or slopes, and the combination of the multiple levels mayhave a better overall performance on various slopes than an individualMLC with one leaf end geometry. For example, for leaves with a leaf tiphaving a flat end geometry or a square shape in a beam's eye view, thebest penumbra performance may occur when shaping a rectangular field(flat field contour). However, such leaves may perform less desirably onsteeper slope or contour as described above. For chamfer leaves, thebest penumbra performance may occur on certain slopes due to aparticular chamfer angle at the leaf ends. By adopting square leaf tipsin one level and chamfer leaves in another level, or by adoptingdifferent chamfer angles in different levels, a multi level MLC mayachieve a better overall performance in shaping fields with differentcontours or slops.

A method of improving penumbra performance using a multi level MLC istherefore disclosed. The multi level MLC may comprise a first MLC in afirst level comprising beam blocking leaves longitudinally movable in afirst direction and a second MLC in a second level comprising beamblocking leaves longitudinally movable in a second direction. The firstdirection is generally parallel with the second direction and the beamblocking leaves of the first MLC laterally offset from the beam blockingleaves of the second MLC in a beam's eye view: In the method, at least afirst leaf of the first MLC in the first level and at least a secondleaf of the second MLC in the second level may be moved into a beam froma radiation source. The first and second leaves may overlap in a beam'seye view. The first and second leaves may be aligned with the radiationsource such that the beam from the source may be tangent on both an endsurface of the first leaf and an end surface of the second leaf.

FIG. 14 schematically illustrates the method described above. It shouldbe noted that the leaves in FIGS. 14A-14C are shown in a side view. Anideal penumbra performance or penumbra reduction may be achieved whenleaves in both levels are aligned with the source because the beamtransmits the most shielding materials (FIG. 14A). As such, the 100%iso-dose lines of the upper and the lower leaves may align each other atthe isocenter plane. The set up in FIG. 14B is less optimal as comparedto the set up in FIG. 14A. The set up in FIG. 14C may be the worst interms of penumbra performance since the leaf end defining the field edgeis closer to the source, which tends to produce greater penumbra due tothe geometric projection effect of the radiation source.

A further method of shaping radiation beams using a multi level MLC isdisclosed. The multi level MLC may comprise a first MLC in a first levelcomprising beam blocking leaves longitudinally movable in a firstdirection and a second MLC in a second level comprising beam blockingleaves longitudinally movable in a second direction. The first directionmay be generally parallel with the second direction and the beamblocking leaves of the first MLC may laterally offset from the beamblocking leaves of the second MLC in a beam's eye view. In the method, aplurality of beam blocking leaves of the first MLC in the first levelmay be moved into a beam from a source, thereby the end surfaces of theplurality of the beam blocking leaves of the first MLC collectivelydefine a first contour in a beam's eye view. The peaks of the firstcontour may form a first imaginary line. A corresponding plurality ofbeam blocking leaves of the second MLC in the second level may be movedinto the beam, thereby the end surfaces of the corresponding pluralityof the beam blocking leaves of the second MLC collectively define asecond contour in a beam's eye view. The peaks of the second contour mayform a second imaginary line. The plurality of leaves of the first MLCand the plurality of leaves the second MLC may be aligned such that thefirst and second imaginary lines may be substantially superimposed in abeam's eye view.

FIGS. 15A-15D schematically illustrate the method described above inshaping a field contour of 45 degree with respect to the leaf traveldirection. It should be noted that the leaves shown in FIGS. 15A-15D arein a beam's eye view. FIG. 15A shows a single level MLC comprisingleaves with leaf tips having a square shape in a beam's eye view. FIGS.15B, 15C and 15D show a two-level MLC each MLC comprising leaves withleaf tips having a square shape in a beam's eye view. For a two levelMLC, a desirable penumbra performance or penumbra reduction may beachieved when the peaks of the contour defined by the leaves of thefirst MLC and the peaks of the contour defined by the leaves of thesecond MLC are aligned (FIG. 15B). The set up shown in FIG. 15C is lessoptimal as compared to FIG. 15B. The set up in FIG. 15D may be the leastdesirable in penumbra performance since the upper level leaves advancein defining the field edge, which tends to produce greater penumbra dueto geometric projection effects of the radiation source.

FIGS. 16A-16D schematically illustrate the method described above inshaping a vertical field contour with respect to the leaf traveldirection. The leaves shown in FIGS. 16A-16D are in a beam's eye view.FIG. 16A shows a single level MLC comprising leaves with leaf tipshaving a square shape in a beam's eye view. FIGS. 16B, 16C and 16D showa two-level MLC each MLC comprising leaves with leaf tips having asquare shape in a beam's eye view. In shaping a vertical field contour,a desirable penumbra performance or penumbra reduction may be achievedwhen the peaks of the contour defined by the leaves of the first MLC andthe peaks of the contour defined by the leaves of the second MLC arealigned (FIG. 16 B). The set up shown in FIG. 16C is less optimal ascompared to the set up of FIG. 16B. The set up shown in FIG. 16D may bethe least desirable in penumbra performance as the upper level leavesadvance in defining the field edge, which tends to produce greaterpenumbra due to geometric projection effects of the radiation source.

A further method of shaping radiation beams is disclosed according towhich the penumbra performance can be optimized by utilizing thepositions of MLC leaves in each of the multi levels. The multi level MLCmay comprise a first MLC in a first level comprising beam blockingleaves longitudinally movable in a first direction and a second MLC in asecond level comprising beam blocking leaves longitudinally movable in asecond direction generally parallel with the first direction. In themethod, at least a first leaf of the first MLC in the first level and atleast a second leaf of the second MLC in the second level may be movedinto a beam from a radiation source. The first and second leaves mayoverlap in a beam's eye view. The penumbra produced by the end surfaceof the first leaf in the isocenter plane and the penumbra produced bythe end surface of the second leaf in the isocenter plane may bedetermined respectively. Preferably the two level leaves are alignedwith the radiation source to produce the smallest penumbra as describedabove. In some situations where the two level leaves cannot be bothaligned with the source, the leaf that produces the smaller penumbra canbe advanced and aligned with the beam from the source to define thecontour of the beam in the isocenter plane as the second best.

In general, the lower level MLC leaves produce smaller penumbra becausethey are located farther from the radiation source and closer to theisocenter plane, assuming the same source spot size and similar leafgeometry. Therefore, in general, the lower level MLC leaves may extendto the field in defining the field contour if a perfect line-up ofleaves of different levels at all locations is difficult to achieve.However, there are situations where the upper level leaves may have asmaller penumbra due to the design or location of the leaves, or due tothe desired field contours. In these situations, the leaves in a levelwhichever produce the smaller penumbra may extend to the field inshaping the field contour if a perfect line-up of leaves of all levelsis difficult.

In some applications, the penumbra may be purposely increased to reducethe treatment plan complexity by adjusting the relative positions awayfrom the best line-up position. The multi level MLC described in thisdisclosure may achieve more uniform and smaller penumbra than that anyindividual level MLC can achieve across the entire region.

FIG. 17 shows images of field edges shaped by a conventional singlelevel MLC and two level MLCs according to embodiments of thisdisclosure. FIG. 17A shows an image produced by using a conventionalsingle level MLC. FIGS. 17B and 17C show images produced by using twolevel MLCs according to embodiments of this disclosure. FIG. 17D showsimages of a chamfer leaf and a leaf tip having a square shape in abeam's eye view. The two level MLC producing the image shown in FIG. 17Bincludes chamfer leaves with a leaf width about same as that of theleaves of the conventional single level MLC producing the image shown inFIG. 17A. The two level MLC producing the image shown in FIG. 17Cincludes square leaves with a leaf width about half of that of thechamfer leaves producing the image shown in FIG. 17B. The overallperformance of the two level MLCs of this disclosure shown in FIGS. 17Band 17C is better than that of the conventional single level MLC shownin FIG. 17A, in step resolution and penumbra etc. Further, the two levelMLC comprising chamfer leaves (FIG. 17B) can achieve an overallperformance similar to that of the two level MLC comprising squareleaves with a leaf width about half of that of the chamfer leaves. Thismeans that a multi level MLC comprising chamfer leaves can achieve agood overall performance with a reduced manufacturing cost.

FIG. 18 shows images of effective penumbra produced by a conventionalsingle level MLC and two level MLCs according to embodiments of thisdisclosure. FIG. 18A is an image showing an effective penumbra (4.7 mm)produced by using a conventional single level MLC. FIGS. 18B and 18C areimages showing effective penumbra (4.3 mm and 4.0 mm respectively)produced by using two level MLCs according to embodiments thisdisclosure. FIG. 18 demonstrates the better penumbra performance of themulti level MLCs of this disclosure over the conventional single levelMLC.

Those skilled in the art will appreciate that various othermodifications may be made within the spirit and scope of the invention.All these or other variations and modifications are contemplated by theinventors and within the scope of the invention.

1-34. (canceled)
 35. A multi level multileaf collimator comprising: afirst multileaf collimator in a first level comprising beam blockingleaves movable in a first direction; and a second multileaf collimatorin a second level comprising beam blocking leaves movable in a seconddirection, wherein the first direction is generally parallel with thesecond direction and the leaves of the first multileaf collimatorlaterally offset the leaves of the second multileaf collimator; whereineach of the beam blocking leaves of the first and second multileafcollimators comprises a top surface proximal to a radiation source whenin use, and the top surface of at least some of the beam blocking leavesof the first multileaf collimator has a non-square shape viewed in adirection perpendicular to the top surface of the at least some of thebeam blocking leaves of the first multileaf collimator.
 36. The multilevel multileaf collimator of claim 25 wherein the top surface of atleast some of the beam blocking leaves of the second multileafcollimator has a non-square shape viewed in a direction perpendicular tothe top surface of the at least some of the beam blocking leaves of thesecond multileaf collimator.
 37. The multi level multileaf collimator ofclaim 25 wherein the top surface of the beam blocking leaves of thesecond multileaf collimator has a square shape viewed in a directionperpendicular to the top surface of the beam blocking leaves of thesecond multileaf collimator.
 38. The multi level multileaf collimator ofclaim 25 wherein the non-square shape of the top surface of the at leastsome of the beam blocking leaves of the first multileaf collimatorcomprises a middle portion orthogonal to the first direction, and abeveled portion on each side of the middle portion.
 39. The multi levelmultileaf collimator of claim 38 wherein the at least some of the beamblocking leaves of the first multileaf collimator have a width, and themiddle portion of non-square shape is about half of the width.
 40. Themulti level multileaf collimator of claim 39 wherein the beveled portionon either side of the middle portion has an angle ranging from 20-80degrees with respect to the middle portion.
 41. The multi levelmultileaf collimator of claim 40 wherein the beveled portion on eitherside of the middle portion has an angle of about 45 degree with respectto the middle portion.
 42. The multi level multileaf collimator of claim40 wherein the beveled portion on either side of the middle portion hasan angle of about 60 degree with respect to the middle portion.
 43. Themulti level multileaf collimator of claim 38 wherein the top surface ofat least some of the beam blocking leaves of the second multileafcollimator has a non-squared shape viewed in a direction perpendicularto the top surface of the at least some of the beam blocking leaves ofthe second multileaf collimator, wherein the non-square shape of the topsurface of the at least some of the leaves of the second multileafcollimator comprise a middle portion orthogonal to the second directionand a beveled portion on each side of the middle portion.
 44. The multilevel multileaf collimator of claim 38 wherein the top surface of thebeam blocking leaves of the second multileaf collimator has a squareshape viewed in a direction perpendicular to the top surface of the atleast some of the beam blocking leaves of the second multileafcollimator.
 45. The multi level multileaf collimator of claim 38 whereinthe top surface of the beam blocking leaves of the second multileafcollimator has a curved shape viewed in a direction perpendicular to thetop surface of the at least some of the beam blocking leaves of thesecond multileaf collimator.
 46. The multi level multileaf collimator ofclaim 38 wherein the top surface of the beam blocking leaves of thesecond multileaf collimator has a pointed angle shape viewed in adirection perpendicular to the top surface of the at least some of thebeam blocking leaves of the second multileaf collimator.
 47. The multilevel multileaf collimator of claim 35 wherein the non-square shape ofthe top surface of the at least some of the beam blocking leaves of thefirst multileaf collimator comprises a middle portion orthogonal to thefirst direction, and two or more beveled portions on each side of themiddle portion.
 48. The multi level multileaf collimator of claim 35wherein the non-square shape of the top surface of the at least some ofthe beam blocking leaves of the first multileaf collimator has a curvedshape, and the top surface of at least some of the beam blocking leavesof the second multileaf collimator has a curved shape viewed in adirection perpendicular to the top surface of the at least some of thebeam blocking leaves of the second multileaf collimator.
 49. The multilevel multileaf collimator of claim 35 wherein each of the beam blockingleaves of the first multileaf collimator offsets a beam blocking leaf inthe second multileaf collimator about half a leaf width.
 50. The multilevel multileaf collimator of claim 35 wherein the beam blocking leavesof the first multileaf collimator comprises a first group of leaveshaving a first leaf width and a second group of leaves on each side ofthe first group of leaves, the second group of leaves have a second leafwidth thicker than the first leaf width.
 51. The multi level multileafcollimator of claim 52 wherein the beam blocking leaves of the secondmultileaf collimator comprises a first group of leaves having a firstleaf width and a second group of leaves on each side of the first groupof leaves of the second multileaf collimator, the second group of leavesof the second multileaf collimator have a second leaf width thicker thanthe first leaf width of the second multileaf collimator.
 52. A multilevel multileaf collimator comprising: a first multileaf collimator in afirst level comprising first beam blocking leaves movable in a firstdirection; and a second multileaf collimator in a second levelcomprising second beam blocking leaves movable in a second directiongenerally parallel with the first direction, wherein each of the firstand second beam blocking leaves comprises a top surface proximal to aradiation source when in use; the top surface of the first beam blockingleaves of the first multileaf collimator comprise has a first shapeviewed in a direction perpendicular to the top surface of the first beamblocking leaves, and the top surface of the second beam blocking leavesof the second multileaf collimator has a second shape viewed in adirection perpendicular to the top surface of the second beam blockingleaves, wherein the second shape is different from the first shape. 53.The multi level multileaf collimator of claim 52 wherein the first beamblocking leaves have a curved shape in a side view with a first radius,and the second beam blocking leaves have a curved shape in a side viewhaving a second radius, wherein the first radius is different from thesecond radius.
 54. The multi level multileaf collimator of claim 52wherein the first shape is a non-square shape, and the second shape is asquare shape.
 55. The multi level multileaf collimator of claim 54wherein the non-square shape comprises a middle portion orthogonal tothe first direction, and a beveled portion on each side of the middleportion.
 56. The multi level multileaf collimator of claim 52 whereinthe first beam blocking leaves comprise chamfer leaves having a firstchamfer angle and the second beam blocking leaves comprise chamferleaves having a second chamfer angle different from the first chamferangle.